This invention relates to an operating table accessory, and more particularly to an accessory for positioning a patient on an operating table for the performance of a lumbar laminectomy, i.e., an operation usually performed to remove a damaged intervertebral disc.
Lumbar laminectomies have been performed in many instances with the patient on the operating table in what has been referred to as the "tuck position", in which the patient is on his knees on the table, the knees being spread apart, the patient's chest and abdomen hanging free. Reference may be made to my article entitled "The Tuck Position for Lumbar-Disc Surgery" at pages 1195-1198 of the September 1967 issue, Vol. 49-A, No. 6, The Journal of Bone and Joint Surgery, a copy of a reprint of this article being appended. A lumbar laminectomy is a complex and delicate operation, with the possibility of complications such as excessive hemorrhage from epidural veins, life-threatening injuries to retroperitoneal major blood vessels and tearing of spinal nerves or the dura. While use of the tuck position appears to have generally satisfactorily reduced the possibility of such complications, I have observed that under certain circumstances, with surgeons of varied experience, the patient might be exposed to risks, particularly two complications:
(1) phlebothrombosis or arterial thrombosis resulting from vascular compression at the hip or knee; and
(2) myoglobulinuria with secondary renal impairment stemming from gastroc-soleus muscle necrosis due to compression by the body's weight. I know of reports in the literature of two such occurrences.